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ADC Practice Question — CMS Risk Assessment & Classification

Progression of existing radiolucencies without new…

Prevention and cariology questions test evidence-based decision-making — fluoride protocols, caries risk assessment, recall scheduling. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

A 48-year-old Medium risk man returns for 6-month recall. Bitewings show two C3 lesions have progressed to C4 since last visit. No new surfaces are involved. Progression of existing radiolucencies without new lesions: how does this affect risk classification?

  • A. Remains Medium — no new lesions means the rate criterion is not exceeded
  • B. Drops to Low — only NEW lesions count for reclassification, not progression
  • C. Stays Medium — recall Medium requires 1 new/year AND/OR progression, and progression is present
  • D. Becomes High — any progression at recall automatically escalates to the highest category
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Sources cited
Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more
Show the answer and cited explanation
Correct answer: C

Recall Medium: '1 new lesion/year AND/OR progression of existing radiolucencies.' Progression alone is sufficient. Low requires BOTH <1 new AND no progression. SOURCE — Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 4

Source: Evans RW et al. CMS for adults, ADJ 2008;53:83-92, Table 4
Remy's study tip — Identify the patient’s risk level first, then match the intervention to the risk.

Exam preparation FAQ

How should I prepare for Preventive Dentistry & Cariology in the ADC exam?
Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.
How do I approach an unfamiliar CMS Risk Assessment & Classification vignette?
Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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